Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $34.17 / $58.43	Professional		$27.54	$34.17	$58.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.37 / $15.56 / $20.84	Professional	26	$13.37	$15.56	$20.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.18 / $18.54 / $30.99	Professional	TC	$14.18	$18.54	$30.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.52 / $35.38 / $46.48	Professional		$26.52	$35.38	$46.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.46 / $16.77 / $20.69	Professional	26	$12.46	$16.77	$20.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.05 / $18.92 / $27.69	Professional	TC	$14.05	$18.92	$27.69
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $34.03 / $34.03 / $37.43	Professional		$34.03	$34.03	$37.43
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $15.67 / $15.67 / $17.23	Professional	26	$15.67	$15.67	$17.23
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $18.37 / $18.37 / $20.21	Professional	TC	$18.37	$18.37	$20.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.28 / $37.28 / $37.28	Facility		$37.28	$37.28	$37.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.95 / $17.95 / $17.95	Facility	26	$17.95	$17.95	$17.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.37 / $40.22 / $77.95	Professional		$27.37	$40.22	$77.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.63 / $18.20 / $36.52	Professional	26	$12.63	$18.20	$36.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.91 / $22.07 / $42.29	Professional	TC	$13.91	$22.07	$42.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.67 / $34.61 / $44.68	Professional		$28.67	$34.61	$44.68
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.55 / $15.62 / $20.16	Professional	26	$13.55	$15.62	$20.16
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $15.12 / $19.00 / $24.52	Professional	TC	$15.12	$19.00	$24.52
Medcost Facility/Professional Facility Modifier Low / Median / High Price $29.08 / $41.05 / $65.42	Facility		$29.08	$41.05	$65.42
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $19.00 / $19.54 / $35.17	Facility	26	$19.00	$19.54	$35.17
Medcost Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $31.00 / $59.00	Professional		$20.00	$31.00	$59.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $16.39 / $30.87 / $57.16	Facility		$16.39	$30.87	$57.16
Sentara Facility/Professional Professional Modifier Low / Median / High Price $17.64 / $37.06 / $63.22	Professional		$17.64	$37.06	$63.22
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $15.07 / $18.53 / $29.84	Professional	26	$15.07	$18.53	$29.84
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $17.01 / $27.24 / $40.32	Professional	TC	$17.01	$27.24	$40.32
United Facility/Professional Professional Modifier Low / Median / High Price $22.11 / $34.61 / $51.66	Professional		$22.11	$34.61	$51.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.58 / $13.82 / $24.04	Professional	26	$10.58	$13.82	$24.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.37 / $17.64 / $31.95	Professional	TC	$11.37	$17.64	$31.95